Influence of aerobic exercise training on post-exercise responses of aortic pulse pressure and augmentation pressure in postmenopausal women

Impact of dynamic explosive resistance exercise with elastic bands on pulse pressure in hypertensive older adults: a randomized crossover study

OBJECTIVE

This study aimed to evaluate the acute responses of pulse pressure (PP), SBP, and DBP to dynamic explosive resistance exercise (DERE) with elastic resistance bands in hypertensive older adults.

METHODS

Eighteen hypertensive older adults were randomly assigned to participate in DERE and control sessions. PP, SBP, and DBP were measured before (baseline) and after each session (immediately, 10, and 20 min after the session). The DERE protocol has five sets of two consecutive exercises.

RESULTS

There was an important clinical decrease in PP (Δ = -7.8 mmHg; dz = 0.7) and in DBP (Δ = -6.3 mmHg; dz = 0.6) favoring the exercise session post-20 min in the intersession comparison. DERE also promoted lowering levels in SBP (140.3 ± 16.0 vs. 126.2 ± 14.3 mmHg; Δ = -14.1 mmHg; P  = 0.04) with a large effect size ( dz = 0.9) post-20 min when compared to the control session.

CONCLUSION

Our findings indicate that DERE with elastic resistance bands improved SBP in hypertensive older adults. In addition, our results support the hypothesis that DERE can an important clinical decrease in PP and DBP. According to this, professionals may have additional exercise training possibilities with elastic resistance bands when prescribing resistance exercises for systemic arterial hypertension treatment in this population.

The effect of acute aerobic exercise on central arterial stiffness, wave reflections, and hemodynamics in adults with diabetes: A randomized cross-over design

BACKGROUND

Individuals with diabetes have greater central arterial stiffness, wave reflections, and hemodynamics, all of which promote the accelerated cardiovascular pathology seen in this population. Acute aerobic exercise has been shown to be an effective strategy for reducing central arterial stiffness, wave reflections, and hemodynamics in healthy individuals; however, the effects of acute aerobic exercise in reducing these outcomes is not well established in people with diabetes. Recently, implementation of high-intensity interval exercise (HIIE) has shown superior improvements in cardiovascular health outcomes when compared to traditional aerobic exercise. Yet, the effect of HIIE on the aforementioned outcomes in people with diabetes is not known. The purpose of this study was to (i) describe the central arterial stiffness, wave reflections, and hemodynamic responses to a bout of HIIE and moderate-intensity continuous exercise (MICE) in adults with diabetes; and (ii) compare the effects of HIIE and MICE on the aforementioned outcomes.

METHODS

A total of 24 adult men and women (aged 29-59 years old) with type 1 (n = 12) and type 2 (n = 12) diabetes participated in a randomized cross-over study. All participants completed the following protocols: (i) HIIE: cycling for 4 × 4 min at 85%-95% of heart rate peak (HR_peak), interspersed with 3 min of active recovery at 60%-70%HR_peak; (ii) MICE: 33 min of continuous cycling at 60%-70%HR_peak; and (iii) control (CON): lying quietly in a supine position for 30 min.

RESULTS

A significant group × time effect was found for changes in central systolic blood pressure (F = 3.20, p = 0.01) with a transient reduction for the HIIE group but not for the MICE or CON groups. There was a significant group × time effect for changes in augmentation index at a heart rate of 75 beats/min (F = 2.32, p = 0.04) with a decrease following for HIIE and MICE but not for CON. For all other measures of central arterial stiffness and hemodynamics, no significant changes were observed (p > 0.05).

CONCLUSION

A bout of HIIE appears to lead to a greater transient reduction in central systolic blood pressure than the reduction observed following MICE; however, both HIIE and MICE improved augmentation index at a heart rate of 75 beats/min in people with diabetes. There was no significant difference in response to HIIE and MICE in all outcomes. This provides preliminary evidence on the role of HIIE on such outcomes in people with diabetes.

Recovery Responses of Central Hemodynamics in Basketball Athletes and Controls After the Bruce Test

Purpose

It is commonly believed that central hemodynamics is closely associated with the presence of cardiovascular events. However, controversial data exist on the acute response of competitive sports on central hemodynamics. Moreover, the central hemodynamic response to exercise is too transient to be investigated. Therefore, this study aimed to investigate the central hemodynamic response in young basketball athletes and controls after 1 h recovery after exercise.

Methods

Fifteen young basketball athletes and fifteen aged-matched controls were recruited to perform the Bruce test. Central hemodynamics were measured and calculated, including heart rate (HR), aortic systolic, diastolic, and pulse pressure (ASP, ADP, and APP), ejection duration (ED), sub-endocardial viability ratio (SEVR), central augmentation index (AIx), and AIx@HR75. Intra-group and inter-group differences were analyzed by two-way repeated measures ANOVA.

Results

ASP significantly decreased at 10 min after exercise in athletes, while it markedly declined at 15 min after exercise in controls (p < 0.01). Additionally, only in the athlete group, ADP significantly decreased at 50 min and at 1 h after exercise. AIx was also significantly reduced at 1-2, 20, 30, and 40 min after exercise (all p < 0.05). Moreover, there were significant differences in the changes of these parameters between the two groups at these measurement points (p < 0.05). SEVR significantly recovered to the baseline level after 30 min, while ED and HR returned to baseline levels at 40 min after exercise in both groups.

Conclusion

Sustained decrease of aortic BPs was sooner after the cessation of exercise in athletes than in controls, and changes of aortic stiffness were more evident in athletes than those in controls during the 1 h recovery period. Additionally, SEVR returned to the baseline sooner than ED and HR in athletes.

Post-exercise Response of Arterial Parameters for Arterial Health Assessment Using a Microfluidic Tactile Sensor and Vibration-Model-Based Analysis: A Proof-of-Concept Study

OBJECTIVE

Arterial stiffness and endothelial function are two established surrogate markers of subclinical atherosclerosis and are quantified by three arterial parameters: elasticity, viscosity and radius of the arterial wall. Yet, the current methods for their assessment are unsuitable for routine use. Post-exercise response of the cardiovascular (CV) system serves as a more sensitive detection of subclinical arterial abnormalities that are not apparent at-rest. The objective of this study is to propose a novel method that can measure post-exercise response of arterial parameters and is also suitable for routine use.

APPROACH

A microfluidic tactile sensor with a location-insensitive configuration was used for arterial pulse signal measurements on six asymptomatic male subjects, offering measurement reliability, ease use by a layperson, and affordability. By treating the arterial pulse signal as a vibration signal of the arterial wall, vibration-model-based analysis of only one measured pulse signal with no calibration was conducted for simultaneous estimation of three arterial parameters. Exercise-intensity-normalized percent changes in arterial parameters were utilized to remove the influence of variation in exercise intensity on post-exercise response, and then their measured values were compared for difference in post-exercise response between the subjects.

MAIN RESULTS

One subject who was obese, on subject who had insomnia, and the oldest subject in the study demonstrated differences in post-exercise response at the radial artery (RA), as compared with the three subjects free of those three factors. Despite a lack of statistical significance, the observed difference at the RA between subjects was supported by (i) their consistency with the related findings in the literature, and (ii) their consistency with the measured values at the carotid artery (CA) and superficial temporal artery (STA) and the anatomical difference between the three arteries.

SIGNIFICANCE

The proposed method has the potential of offering an affordable and convenient diagnosis tool for routine arterial health assessment.

Aerobic exercise training enhances cerebrovascular pulsatility response to acute aerobic exercise in older adults

The brain's low resistance ensures a robust blood flow throughout systole and diastole and is susceptible to flow pulsatility. Increased cerebral pulsatility contributes to the progression of cerebrovascular disease. Although aerobic exercise affects vascular function, little is known about the effect of exercise on the cerebral pulsatility index in older adults. The aim of this study was to investigate the effect of exercise training on the post‐exercise cerebral pulsatility response in older adults. Ten healthy older adults participated in a 12‐week exercise training intervention. Before and after the intervention, we measured the pulsatility index of the middle cerebral artery by means of transcranial Doppler method at baseline and following a cycling exercise bout performed at an intensity corresponding to the ventilatory threshold. Before exercise training, there was no significant change in the cerebral pulsatility response to an acute bout of cycling exercise. However, after the intervention, cerebral pulsatility decreased significantly following 30 min of an acute cycling exercise (P < 0.05). This study demonstrated that cerebral pulsatility index did not change following an acute bout of cycling exercise at an intensity corresponding to ventilatory threshold, but that, after 12 weeks of exercise training, cerebral pulsatility index was reduced at 30 min after a single bout of cycling exercise. These results suggest that long‐term aerobic exercise training may enhance the post‐exercise reduction in pulsatility index in older adults.

Effects of exercise intensity and cardiorespiratory fitness on the acute response of arterial stiffness to exercise in older adults

PURPOSE

Increased arterial stiffness is observed with ageing and in individuals with low cardiorespiratory fitness ([Formula: see text]O_2peak), and associated with cardiovascular risk. Following an exercise bout, transient arterial stiffness reductions offer short-term benefit, but may depend on exercise intensity. This study assessed the effects of exercise intensity on post-exercise arterial stiffness in older adults with varying fitness levels.

METHODS

Fifty-one older adults (72 ± 5 years) were stratified into fitness tertiles ([Formula: see text]O_2peak: low-, 22.3 ± 3.1; mid-, 27.5 ± 2.4 and high-fit 36.3 ± 6.5 mL kg^-1 min^-1). In a randomised order, participants underwent control (no-exercise), moderate-intensity continuous exercise (40% of peak power output; PPO), and higher-intensity interval exercise (70% of PPO) protocols. Pulse wave velocity (PWV), augmentation index (AIx75) and reflection magnitude (RM) were assessed at rest and during 90 min of recovery following each protocol.

RESULTS

After control, delta PWV increased over time (P < 0.001) and delta RM was unchanged. After higher-intensity interval exercise, delta PWV (P < 0.001) and delta RM (P < 0.001) were lower to control in all fitness groups. After moderate-intensity continuous exercise, delta PWV was not different from control in low-fit adults (P = 0.057), but was lower in the mid- and higher-fit older adults. Post-exercise AIx75 was higher to control in all fitness groups (P = 0.001).

CONCLUSIONS

In older adults, PWV increases during seated rest and this response is attenuated after higher-intensity interval exercise, regardless of fitness level. This attenuation was also observed after moderate-intensity continuous exercise in adults with higher, but not lower fitness levels. Submaximal exercise reveals differences in the arterial stiffness responses between older adults with higher and lower cardiorespiratory fitness.

All-Extremity Exercise Training Improves Arterial Stiffness in Older Adults

Large elastic arteries stiffen with age, which predisposes older adults to increased risk for cardiovascular disease. Aerobic exercise training is known to reduce the risk for cardiovascular disease, but the optimal exercise prescription for attenuating large elastic arterial stiffening in older adults is not known.

PURPOSE

The purpose of this randomized controlled trial was to compare the effect of all-extremity high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on aortic pulse wave velocity (PWV) and carotid artery compliance in older adults.

METHODS

Forty-nine sedentary older adults (age = 64 ± 1 yr), free of overt major clinical disease, were randomized to HIIT (n = 17), MICT (n = 18), or nonexercise controls (CONT; n = 14). HIIT (4 × 4 min at 90% HRpeak interspersed with 3 × 3 min active recovery at 70% HRpeak) and isocaloric MICT (70% HRpeak) were performed on an all-extremity non-weight-bearing ergometer, 4 d·wk for 8 wk under supervision. Aortic (carotid to femoral PWV [cfPWV]) and common carotid artery compliance were assessed at pre- and postintervention.

RESULTS

cfPWV improved by 0.5 m·s in MICT (P = 0.04) but did not significantly change in HIIT and CONT (P > 0.05). Carotid artery compliance improved by 0.03 mm·mm Hg in MICT (P = 0.001), but it remained unchanged in HIIT and CONT (P > 0.05). Improvements in arterial stiffness in response to MICT were not confounded by changes in aortic or brachial blood pressure, HR, body weight, total and abdominal adiposity, blood lipids, or aerobic fitness.

CONCLUSION

All-extremity MICT, but not HIIT, improved central arterial stiffness in previously sedentary older adults free of major clinical disease. Our findings have important implications for aerobic exercise prescription in older adults.

Comparison between Central and Brachial Blood Pressure in Hypertensive Elderly Women and Men

AIM

To compare the values of central and brachial systemic blood pressure (SBP) between women and men over 60 years of age with systemic arterial hypertension.

METHODS

This study was a quantitative, descriptive, cross-sectional study with elderly patients admitted to and selected from spontaneous and scheduled demand at basic health units in Uberlândia, Minas Gerais, Brazil, between March 2013 and March 2014. We included 69 study participants and compared central and brachial SBP using a Sphygmocor® XCEL device (AtCor Medical, Sydney, Australia).

RESULTS

Significant differences were found in the blood pressure values of the whole population in the central versus brachial systolic blood pressure (SP) [140(21) versus 153(23) mmHg] and in the central versus brachial pulse pressure (PP) [55(18) versus 70(18) mmHg]. Additionally, females exhibited higher blood pressure levels than males [central SP 144(23) versus 134(16) mmHg and brachial SP 161(26) versus 148(18) mmHg and central PP 62(17) versus 45(14) mmHg and brachial PP 80(21) versus 63(15) mmHg, resp.].

CONCLUSION

Elderly women exhibited higher blood pressure values than elderly hypertensive men.

A systematic review on the effect of acute aerobic exercise on arterial stiffness reveals a differential response in the upper and lower arterial segments

The objective of this systematic review was to provide insight into the controversy that still abounds as to the impact of acute aerobic exercise on immediate changes in arterial stiffness. Electronic databases were searched to identify articles assessing the effects of acute aerobic exercise on parameters of arterial stiffness. Eligible studies included arterial stiffness measurements before and after acute aerobic exercise in healthy human subjects. Forty-three studies were included. The effect of acute aerobic exercise on arterial stiffness was found to be dependent on the anatomical segment assessed, and on the timing of the measurement post-exercise. Arterial stiffness of the central and upper body peripheral arterial segments was found to be increased relative to resting values immediately post-exercise (0-5 min), whereas, thereafter (>5 min), decreased to a level at or below resting values. In the lower limbs, proximal to the primary working muscles, arterial stiffness decreased immediately post-exercise (0-5 min), which persisted into the recovery period post-exercise (>5 min). This systematic review reveals a differential response to acute exercise in the lower and upper/central arterial segments in healthy adult subjects. We further showed that the effect of acute aerobic exercise on arterial stiffness is dependent on the timing of the measurements post-exercise. Therefore, when assessing the overall impact of exercise on arterial stiffness, it is important to consider the arterial segment being analyzed and measurement time point, as failure to contextualize the measurement can lead to conflicting results and misleading clinical inferences.